dc.contributor |
Epicentre, Paris, France; Médecins Sans Frontières, Arua, Uganda; Laboratory of Virology, Paris Descartes University, Paris, France; Laboratory of Toxicology, Bicêtre Hospital, Kremlin Bicêtre, France; Médecins Sans Frontières, Paris, France; Medical and Administrative Hospital Direction, Arua Regional Hospital, Arua, Uganda; International and Environmental Health, Institute of Social and Preventive Medicine, Bern, Switzerland |
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dc.creator |
Ahoua, L |
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dc.creator |
Guenther, G |
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dc.creator |
Pinoges, L |
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dc.creator |
Anguzu, P |
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dc.creator |
Chaix, M L |
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dc.creator |
Le Tiec, C |
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dc.creator |
Balkan, S |
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dc.creator |
Olson, D |
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dc.creator |
Olaro, C |
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dc.creator |
Pujades-Rodriguez, M |
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dc.date |
2009-06-03 |
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dc.date.accessioned |
2017-01-31T07:14:29Z |
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dc.date.available |
2017-01-31T07:14:29Z |
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dc.identifier |
BMC Infect Dis 2009;9(1):81 |
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dc.identifier |
1471-2334 |
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dc.identifier |
19493344 |
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dc.identifier |
10.1186/1471-2334-9-81 |
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dc.identifier |
http://hdl.handle.net/10144/71874 |
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dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/71874 |
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dc.identifier |
BMC Infectious Diseases |
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dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/71874 |
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dc.description |
ABSTRACT: BACKGROUND: Little is known about immunovirological treatment outcomes and adherence in HIV/AIDS patients on antiretroviral therapy (ART) treated using a simplified management approach in rural areas of developing countries, or about the main factors influencing those outcomes in clinical practice. METHODS: Cross-sectional immunovirological, pharmacological, and adherence outcomes were evaluated in all patients alive and on fixed-dose ART combinations for 24 months, and in a random sample of those treated for 12 months. Risk factors for virological failure (>1,000 copies/mL) and subtherapeutic antiretroviral (ARV) concentrations were investigated with multiple logistic regression. RESULTS: At 12 and 24 months of ART, 72% (n=701) and 70% (n=369) of patients, respectively, were alive and in care. About 8% and 38% of patients, respectively, were diagnosed with immunological failure; and 75% and 72% of patients, respectively, had undetectable HIV RNA (<400 copies/mL). Risk factors for virological failure (>1,000 copies/mL) were poor adherence, tuberculosis diagnosed after ART initiation, subtherapeutic NNRTI concentrations, general clinical symptoms, and lower weight than at baseline. About 14% of patients had low ARV plasma concentrations. Digestive symptoms and poor adherence to ART were risk factors for low ARV plasma concentrations. CONCLUSIONS: Efforts to improve both access to care and patient management to achieve better immunological and virological outcomes on ART are necessary to maximize the duration of first-line therapy. |
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dc.language |
en |
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dc.relation |
http://www.biomedcentral.com/1471-2334/9/81 |
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dc.rights |
Archived with thanks to BMC infectious diseases |
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dc.title |
Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda |
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dc.type |
Article |
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